Pain intensity was not significantly reduced by dronabinol, compared with placebo after 16 weeks of treatment.

Dronabinol provides a safe and effective treatment option in patients with symptoms of neuropathic pain associated with multiple sclerosis, according to findings from a randomized double-blind placebo-controlled trial published in European Neurology.

Pain intensity was not significantly reduced by dronabinol vs placebo after 16 weeks of treatment (point reduction from baseline levels: 1.92±2.01 [30%] vs 1.81±1.94 [27%]). However, pain relief was found to be clinically relevant in all patients. Also, both groups demonstrated similar improvements in quality of life (evaluated with the 36-Item Short-Form Survey SF-36) at the end of treatment.

The “pronounced placebo analgesia” observed in this study represents 1 limitation of the findings. According to the authors, patient expectations, a close relationship between patient and physician, and behavioral conditioning may have contributed to the increased responses to placebo.

Compared with pregabalin and opioids, which tend to have a high abuse potential, the study investigators noted that “a relative stable dose of dronabinol over a long period suggests that there is no tolerance development” or severe level of dependency.